Can a giant bureaucracy and a bunch of idealistic missionaries really save the Downtown Eastside?

The Downtown Eastside has become our regional mental-health institution, as most of the world knows.

What that means, among other things, is trying to deliver health care to thousands of people who are spread out across a few dozen city blocks instead of one convenient large institution, who can’t be compelled to show up for medical appointments, who end up flailing around between the health and the justice systems, and who can’t be locked up in a room when things get out of hand.

To deal with the whole gigantic mess, the bureaucracy of Vancouver Coastal Health is forced to interact with a host of non-profits to deliver services on the street and to try to manage the many people who come into the area on a mission to save the world. The result, surprise: A lot of conflict.

Coastal Health commissioned a study and report by writer Charles Campbell last year, one that didn’t flinch from describing the conflicts in the area. The health authority has put itself on a path to try to reform its services. But, as I detail in my Vancouver magazine piece here, that’s a Titanic job.